Attachment B - Annual Affidavit - RFB 758 2600000198.pdf
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- Collator for LSCC Print Shop
- Solicitation number
- RFB 758 2600000198 1
- Issued by
- Elliott County, Kentucky
About this file
This is a Required Affidavit form for Bidders, Offerors, and Contractors issued by the Commonwealth of Kentucky pursuant to Kentucky Revised Statutes (KRS) 45A.110 and 45A.115. The affidavit is effective for one year from the date of execution and must be completed, notarized, and submitted by any bidder, offeror, or contractor seeking to be awarded a contract or contract renewal with the Commonwealth. An authorized representative of the contracting party must attest under penalty of perjury that the contractor has not knowingly violated campaign finance laws of the Commonwealth and that awarding the contract will not violate any provision of Kentucky's campaign finance laws. The Commonwealth retains the right to request an updated affidavit at any time during the contract period.
The form requires the contractor's authorized representative to provide signature, printed name, title, and date of execution along with the bidder or offeror's name, address, and Commonwealth of Kentucky vendor code. The attestation must be notarized before a notary public, with the notary providing their signature, commission expiration date, and identifying information including the state and county where the oath is administered. This affidavit serves as a compliance verification document that all bidders and offerors must complete to maintain eligibility for state contract awards.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A - RFB 758 2600000198 - 11-19-2025.pdf | ||
| Final_RFB_758_2600000198_1_SO_FORM.PDF |
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Text version
Rev. 9-16-22 Required Affidavit for Bidders, Offerors and Contractors
(KRS 45A.110 & 45A.115)
Affidavit Effective for One (1) Year from Date of Execution
Instructions: Pursuant to KRS 45A.110 and 45A.115, a bidder, offeror, or contractor (“Contractor”) is required to submit a Required Affidavit for Bidders, Offerors, and Contractors to be awarded a contract, or for the renewal of a contract. An authorized representative of the contracting party must complete the attestation below, have the attestation notarized, and return the completed affidavit to the Commonwealth.
Attestation
As a duly authorized representative for the Contractor, I swear and affirm under penalty of perjury, that that the Contractor has not knowingly violated campaign finance laws of the Commonwealth of Kentucky and that the award of a contract will not violate any provision of the campaign finance laws of the Commonwealth. For purposes of this attestation, "Knowingly" means that the bidder or offeror is aware or should have been aware of the existence of a violation. The bidder or offer understands that the Commonwealth retains the right to request an updated affidavit at any time.
Signature Printed Name
Title Date
Bidder or Offeror Name: __________________________________________________________
Address: __________________________________________________________
Commonwealth of Kentucky Vendor Code (If known): _______________
Subscribed and sworn to before me this _____ day of _______________, ____________.
State of: ___________________ Notary: ___________________________________
County of: _________________ My Commission Expires: _____________________
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